RESUMO
Perioperative blood loss in pediatric cardiac surgery is related to the significant increase of blood transfusion,which leads to adverse events of blood transfusion and worsens the prognosis.Perioper-ative blood protection has important clinical significance in reducing adverse reactions to blood transfusion and alleviating blood supply tension.Cardiopulmonary bypass plays an important role in the management of perioperative blood protection practices.This article reviews the latest progress for blood protection in perfu-sion and blood product infusion strategies during cardiopulmonary bypass,providing reference for physicians to transfuse blood in children undergoing cardiopulmonary bypass during pediatric heart surgery.
RESUMO
Objective To systematically evaluate the efficacy of β-blocker in pediatric patients with congestive heart failure and congenital heart disease,and to provide evidence for clinician.Methods Before-and-after self-control study and randomized controlled trials were retrieved from PubMed,EMbase,the Cochrane Library,CNKI,WanFang,VIP databases,and the search time was from the establishment of the database to October 31,2023.All outcomes included left ventricular ejection fraction(LVEF),left ventricular fraction shortening,LVFS),left ventricular end-diastolic dimension(LVDD),Left ventricular end-systolic dimension(LVSD),N-terminal proB brain natriuretic peptide(NT-proBNP),heart rate,blood pressure and cardiac function improvement.Results A total of 20 trials involving 1 068 children with heart failure(dilated cardiomyopathy and endocardial fibroelastosis were included.Meta-analysis results showed that the addition of β-blockers(metoprolol succinate,bisoprolol and carvedilol)on the basis of conventional drug therapy for heart failure had significant effects on LVEF[MD=13.06,95%CI(11.67,14.45),P<0.001],LVFS[MD=6.96,95%CI(6.54,7.37),P<0.001],LVDD[MD=-6.43,95%CI(-7.58,-5.28),P<0.001]and LVSD[MD=-8.30,95%CI(-8.83,-7.76),P<0.001]were significantly improved.In addition,blood pressure,heart rate,NT-proBNP and cardiac function could also be improved.Conclusion The combination regimen of β-blockers on the basis of conventional drug therapy for heart failure can improve cardiac function and symptoms of heart failure in children with congestive heart failure.Therefore,it is recommended that β-blockers should be actively used in the conventional treatment regimen for children with congestive heart failure.
RESUMO
Children and adults differ significantly in physiology, biochemistry and immune function, which leads to significant differences in blood transfusion strategies between children and adults. To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children, the National Health Commission organized the formulation and release of the health industry standard Guideline for Pediatric Transfusion (WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard, and explain and interpret the preparation of the " scope", " general provisions" and " factors to consider" of the Standard, hoping to contribute to the understanding and implementation of the Standard.
RESUMO
INTRODUCTION@#Observational studies have revealed an association between waist circumference (WC) and atrial fibrillation (AF). However, it is difficult to infer a causal relationship from observational studies because the observed associations could be confounded by unknown risk factors. Therefore, the causal role of WC in AF is unclear. This study was designed to investigate the causal association between WC and AF using a two-sample Mendelian randomization (MR) analysis.@*METHODS@#In our two-sample MR analysis, the genetic variation used as an instrumental variable for MR was acquired from a genome-wide association study (GWAS) of WC (42 single nucleotide polymorphisms with a genetic significance of P <5 × 10 -8 ). The data of WC (from the Genetic Investigation of ANthropometric Traits consortium, containing 232,101 participants) and the data of AF (from the European Bioinformatics Institute database, containing 55,114 AF cases and 482,295 controls) were used to assess the causal role of WC on AF. Three different approaches (inverse variance weighted [IVW], MR-Egger, and weighted median regression) were used to ensure that our results more reliable.@*RESULTS@#All three MR analyses provided evidence of a positive causal association between high WC and AF. High WC was suggested to increase the risk of AF based on the IVW method (odds ratio [OR] = 1.43, 95% confidence interval [CI], 1.30-1.58, P = 2.51 × 10 -13 ). The results of MR-Egger and weighted median regression exhibited similar trends (MR-Egger OR = 1.40 [95% CI, 1.08-1.81], P = 1.61 × 10 -2 ; weighted median OR = 1.39 [95% CI, 1.21-1.61], P = 1.62 × 10 -6 ). MR-Egger intercepts and funnel plots showed no directional pleiotropic effects between high WC and AF.@*CONCLUSIONS@#Our findings suggest that greater WC is associated with an increased risk of AF. Taking measures to reduce WC may help prevent the occurrence of AF.
Assuntos
Humanos , Fibrilação Atrial/genética , Estudo de Associação Genômica Ampla , Circunferência da Cintura/genética , Biologia Computacional , Bases de Dados FactuaisRESUMO
High-quality donor heart is the prerequisite and fundamental guarantee for successful heart transplantation. Reasonable donor heart preservation technique plays a key role in improving the quality of donor heart and the prognosis of heart transplantation. Static cold storage (SCS) is currently the standard preservation technique for cardiac allograft. However, it is prone to cause severe cold ischemia injury to the donor heart, and it is impossible to evaluate heart function during SCS. As an important emerging technique of organ preservation, machine perfusion better matches with physiological conditions compared with SCS, which may remove metabolic wastes and provide basic substances for metabolic needs during organ preservation, prolong the preservation time and improve the preservation effect to a certain extent. Besides, it may also effectively evaluate organ function and improve clinical prognosis of heart transplantation. Meantime, it can also repair organ damage, significantly optimize organ quality and improve the utilization rate of donor organs. In this article, research status of machine perfusion of donor heart was reviewed.
RESUMO
Defining and visualizing the three-dimensional (3D) structures of pharmaceuticals provides a new and important tool to elucidate the phenomenal behavior and underlying mechanisms of drug delivery systems. The mechanism of drug release from complex structured dosage forms, such as bilayer osmotic pump tablets, has not been investigated widely for most solid 3D structures. In this study, bilayer osmotic pump tablets undergoing dissolution, as well as after dissolution in a desiccated solid state were examined, and visualized by synchrotron radiation micro-computed tomography (SR-μCT). In situ formed 3D structures at different in vitro drug release states were characterized comprehensively. A distinct movement pattern of NaCl crystals from the push layer to the drug layer was observed, beneath the semi-permeable coating in the desiccated tablet samples. The 3D structures at different dissolution time revealed that the pushing upsurge in the bilayer osmotic pump tablet was directed via peripheral "roadways". Typically, different regions of the osmotic front, infiltration region, and dormant region were classified in the push layer during the dissolution of drug from tablet samples. According to the observed 3D microstructures, a "subterranean river model" for the drug release mechanism has been defined to explain the drug release mechanism.
RESUMO
Objective:To evaluate the predictive value of the serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration for postoperative acute kidney injury (AKI) in neonates undergoing cardiac surgery.Methods:Perioperative data of 110 consecutive neonates (≤28 days) who underwent cardiac surgery in our hospital from October 2017 to May 2021, were collected retrospectively.According to pROCK criteria, the patients were divided into AKI group and non-AKI group.Demographics, predominant diagnosis, laboratory examination, perioperative management and postoperative outcomes were compared between two groups.The concentration of serum NT-proBNP was routinely measured within 12 h after operation.Multivariate logistic regression analysis was performed for the association between serum NT-proBNP and postoperative AKI.Receiver operating characteristic curve was drawn, and the predictive value of serum NT-proBNP for postoperative AKI was determined according to the area under the curve.Results:A total of 106 neonates were enrolled, and the incidence of postoperative AKI was 54.7%.There were significant difference in the baseline hemoglobin concentration, hematocrit and serum creatinine and serum NT-proBNP concentration between AKI group and non-AKI group ( P<0.05). Multivariate logistic regression analysis indicated that NT-proBNP level was an independent risk factor for AKI after cardiac surgery in neonates ( odds ratio 2.49, 95% confidence interval 1.183-5.23, P=0.016). The area under the curve of NT-proBNP predicting AKI after cardiac surgery was 0.66 (95% confidence interval 0.56-0.76, P=0.007). Conclusions:Elevated serum NT-proBNP concentration is an independent risk factor for AKI after cardiac surgery in neonates and has a certain predictive value for AKI, and close monitoring of perioperative NT-proBNP level is helpful for early identification of high-risk neonates.
RESUMO
OBJECTIVE:To construct the evaluation system for TCM pharmaceutical care quality in public hospitals of Jilin province,and to provide reference for improving the quality of TCM pharmaceutical care in public hospitals. METHODS :On Nov. 2020,20 relevant personnel and 10 experts in the field of TCM in Jilin province were selected by theoretical sampling method and objective sampling method ,respectively;grounded theory and Delphi method were adopted to sort out and score the evaluation system of TCM pharmaceutical care quality in public hospitals. Analytic hierarchy process (AHP)was used to determine the weight of each index. RESULTS :In the two rounds of evaluation ,experts’enthusiasm,authority and opinion coordination were relatively high. Finally ,the evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin Province was constructed , consisting of 5 criterion layer indexes and 27 field layer indexes. The weights of the five criterion layer indexes from high to low are 0.290 for TCM pharmaceutical care management ,0.283 for TCM pharmaceutical care equipment ,0.163 for TCM prescription rationality,0.150 for TCM quality management ,0.144 for TCM pharmaceutical care ability. CONCLUSIONS :The evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin province established in this study is scientific and applicable , and provides a basis for improving the quality of TCM pharmaceutical care in public hospitals. Public hospitals can set up priority improvement dimensions according to the results of the quality evaluation system ,and focus the limited human and material resources on priority improvement indexes.
RESUMO
Objective@#To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs).@*Methods@#The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs.@*Results@#6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology.@*Conclusion@#There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.
RESUMO
Objective:To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs).Methods:The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs.Results:6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology.Conclusion:There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.
RESUMO
OBJECTIVE@#To explore the effect of mild hypothermia on inflammatory response and angiogenesis in brain tissues of rats with intracerebral hemorrhage (ICH) and its possible mechanism for improving behavioral deficits of the rats After ICH.@*METHODS@#A total of 120 healthy male SD rats were randomly divided into sham operation group, ICH group and mild hypothermia group. Rat models of ICH were established in the latter two groups by stereotactic injection of autogenous blood in the brain, and the rats in the sham operation group received injection of normal saline in the same manner. At 15 min after modeling, the rats in hypothermia group were subjected to mild hypothermia (30-32 ℃) for 8 h followed by rewarming (37-38 ℃); the body temperature was maintained at 37-38 ℃ in the other two groups. At 2, 4, 7, 14 and 21 days after the treatment, Longa scoring, balance beam scoring and Berderson scoring were used to evaluate the behavioral deficits of the rats. Immunohistochemical staining was used to detect the protein expressions of tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in the brain tissue of the rats, and the mRNA expressions of α subunit of hypoxia-inducible factor 1 (HIF1-α) and vascular endothelial growth factor (VEGF) were detected using RT- PCR.@*RESULTS@#At 2, 4, 7, 14 and 21 days after the treatment, the behavioral scores of the rats were significantly higher in ICH group and mild induced hypothermia group than in the sham operation group ( < 0.05 or 0.01). The protein expressions of TNF-α and NF-κB and mRNA expressions of HIF1-α and VEGF were significantly higher in ICH group and mild hypothermia group than in the sham operation group ( < 0.01). The behavioral scores were significantly lower in mild hypothermia group than in ICH group ( < 0.05), and the protein expressions of TNF-α and NF-κB were lower and the mRNA expressions of HIF1- α and VEGF were higher in mild hypothermia group than in ICH group ( < 0.05 or 0.01).@*CONCLUSIONS@#Mild hypothermia can improve behavioral deficits in rats with ICH possibly by antagonizing brain inflammation and promoting angiogenesis.
RESUMO
OBJECTIVE: To rapidly identify chemical components of Zhitong huazheng capsules (shorted for “ZTHZC”), and to provide reference for further elucidating the pharmacodynamic material basis and overall quality control. METHODS: UPLC-Q-TOF/MS method was adopted to separate the chemical components of ZTHZC. By reviewing literatures that related to chemical components of ZTHZC and its single Chinese traditional medicinal crops, the chemical structure of the chemical components was saved into a .mol format file, and supplemented the UNIFI database. The chemical constituents of ZTHZC were qualitatively analyzed by UNIFI database screening, and validated according to their precise molecular mass, characteristic ions, neutral loss, secondary mass spectrometry cleavage, chromatographic retention behavior, combined reference information and literature reports. RESULTS: A total of 70 chemical components were identified in this experiment, including 38 organic acids and organic acid esters, 8 alkaloids, 9 flavonoids, 5 triterpenoid saponins, 5 aldehydes, 2 ketones, 1 quinone, 1 polyacetylene and 1 monoterpenoid. CONCLUSIONS: This study provides a rapid detection and identification method for chemical components of ZTHZC, and also provides a scientific basis for the clarification of ZTHZC’s quality control and pharmacodynamics.
RESUMO
OBJECTIVE@#To explore the genetic basis for a fetus featuring growth restriction and validate the effectiveness of a novel noninvasive prenatal testing (NIPT) technique for the detection of chromosomal microdeletions.@*METHODS@#Next-generation sequencing(NGS) and fluorescence in situ hybridization(FISH) were used to analyze the DNA of the fetus. Conventional G-banding was used to analyze the karyotypes of the fetus and its parents. High-throughput sequencing was used to analyze free fetal DNA.@*RESULTS@#NGS analysis has revealed a 4.88 Mb deletion at 15q11.2-q13.1 region in the fetus, which has a 99% overlap with the critical region of Prader-Willi syndrome (Type 2) and Angelman syndrome (Type 2) and encompassed critical genes including SNRPN and UBE3A. NIPT also revealed a 4.6 Mb deletion at 15q12, which was consistent with the results of fetal cord blood and amniotic DNA testing. FISH assay has confirmed the result of NGS. By karyotying, all subjects showed a normal karyotypes at a level of 320~400 bands.@*CONCLUSION@#It is quite necessary to carry out genetic testing on fetuses showing growth restriction. NIPT for fetal chromosomal microdeletions/microduplication syndromes is highly accurate for the diagnosis of Prader-Willi/Angelman syndrome.
Assuntos
Feminino , Humanos , Gravidez , Síndrome de Angelman , Bandeamento Cromossômico , Cromossomos Humanos Par 15 , Feto , Hibridização in Situ Fluorescente , Síndrome de Prader-WilliRESUMO
Objective To summarize the surgical strategies of orthotopic cardiac transplantation for congenital dextrocardia .Methods Three patients with congenital dextrocardia suffered from endstage heart failure and underwent orthotopic cardiac transplantation from March 2014 to September 2017 .They were aged 10 ,29 ,13 years respectively .Donor hearts were from brain death donors and procured with extra length on inferior vena cava , aorta and pulmonary artery tissues . After cardiectomy , left atrial-atrial anastomosis was performed initially between donor ' s left-upper pulmonary vein orifices and recipient's left-lower pulmonary vein orifices .Apex was orientated at a 90 degrees' clockwise to right . Then aorta ,inferior and superior vena cava and last pulmonary artery were anastomosed continuously . The prosthetic conduits were also used owing to a lack of tissue . Results All operations were successful . The cold ischemic time was (130-375 ) (251 .00 ± 122 .53) min ,cardiopulmonary bypass time (127-212 )(179 .67 ± 55 .72 ) min and aortic clamp time (38-105 ) (65 .33 ± 35 .166) min . Two patients had stable hemodynamics and recovered well after HTx .During a follow-up period of 1 .5-3 .5 years , echocardiography showed excellent cardiac functions without blood flow obstruction . Chest radiology showed well-placed donor heart in right mediastinum .One left-sided patient with total cavopulmonary connection before HTx died at 59 days after HTx because of pneumonia and multiple organ failure .Conclusions Heart transplantation is curative for patients with congenital dextrocardia and surgical strategies are the key factor of successful treatment .
RESUMO
In order to make the pharmacy work of the county, township and community hospitals in our city gradually be undertaken by specially trained pharmacists, our hospital has carried out standardized and systematic training for pharmacists in primary hospitals and pharmacists who have just entered their posts, so that the trainees can basically master standardized prescription examination, dispensing, drug administration and pharmaceutical care as well as other related skills. At the same time, according to the actual training in our hospital, the status quo and existing problems of standardized training of pharmacists in our hospital have been summarized, and some suggestions for future pharmacist training have been put forward.
RESUMO
When having completed the treatments of acute disease ,the hospitalized elderly patients are often not able to return home immediately due to poor physical and mental conditions. They need a period of integrated medical care for recovering independent living ability. Intermediate care provides appropriate treatment and intensive rehabilitation for elderly patients in a relatively short period after acute diseases to restore optimal health ,reduce readmission ,and return self-care ability as far as possible. Intermediate care can fill the gap between acute-term treatment and long-term care. This review is about the development of intermediate care ,the mode and the research of intermediate care in different countries ,equipment configuration and human resource allocation ,and the outlook for intermediate care.
RESUMO
Objective@#To analyze pre- and post-operation electrocardiograms (ECGs) features of patients underwent orthotopic heart transplantation (OHT), and provide evidences for identifying and analyzing post OHT ECGs.@*Methods@#Nine hundreds and ninty-eight pre- and post- OHT standard 12-leads ECGs from 110 consecutive patients, who underwent OHT in our hospital from May 2008 to May 2014, were analyzed.@*Results@#The mean heart rate(HR)was (86.9±16.4) beats per minute before OHT, and (100.0±0.4) beats per minute after OHT. P wave′s amplitude, duration, amplitude multiplied by duration of donor heart in lead Ⅱ were (0.124±0.069)mV, (111.1±17.2)ms, (14.34±9.51)mV·ms before OHT; (0.054±0.037)mV, (86.9±27.0)ms, (5.02±4.03)mV·ms at 1 month after OHT; (0.073±0.049)mV, (93.9±17.5) ms, (7.00±4.81)mV·ms at 6 years after OHT. ECGs rotation occurred in 83.64%(92/110) patients after OHT, and prevalence of clockwise rotation was 76.36%(84/110). Sinus tachycardia was evidenced in 99.09%(109/110) patients after OHT, and incomplete right bundle branch block was present in 60.91%(67/110) patients after OHT. Pseudo complete atrioventricular block mostly occurred at 2 days after OHT. Prevalence of double sinus rhythm was 27.95%(263/941) post OHT, 40% of them occurred between the 1st and the 2nd month post OHT; the atrial rate of recipient hearts was (104.0±10.2) beats per minucte between the 3rd and the 6th month post OHT, and was (95.3±4.2) beats per minucte between the 4th year and the 5th year. P wave′s amplitude, duration, amplitude multiplied by duration of recipient heart in lead Ⅱ were (0.066±0.055) mV, (52.8±34.7) ms, (4.67±4.95) mV·ms at 1 month after OHT, (0.043±0.040)mV, (44.4±40.5) ms , (3.11±3.61) mV·ms between the 1st year and 2nd year after OHT. The absolute value of P-wave(originating from the donor heart) terminal force in chest leads increased in 48.99%(461/941) patients post OHT, the P-wave terminal force of V1 , V2 and V3 were -0.044(-0.066, -0.028), -0.060(-0.087, -0.038), -0.035(-0.056, 0) mm·s. Notched P wave in chest leads was presented in 10.31%(97/941) patients post OHT. PR segment depression in chest leads occurred in 60.24%(100/166) patients between the 3rd month and the 6th month, the incidence of PR segment depression in V1 , V2 and V3 was 21.04%(198/941), 37.41%(352/941) and 28.69%(270/941), respectively.@*Conclusions@#OHT is related to significantly changed ECGs. The mean HR increased significantly after OHT, then decreased gradually after half a year to one year, but it was still higher than preoperative mean HR after five or six years; the P waves of donor heart were usually inconspicuous or small in first month after OHT, and they became bigger after 2 months, and their duration and amplitude then became relatively steady afterwards. ECGs rotation, especially the clockwise rotation, was common post OHT. A variety of arrhythmias originating from the donor heart including sinus tachycardia and incomplete right bundle branch block could be found. Pseudo complete atrioventricular block could also be found in the early phase after OHT. With the extension of time, the incidence of double sinus rhythm reduced gradually. The atrial rate and P wave of recipient heart presented with a tendency to become lower. The absolute value of P-waves(originating from the donor heart) terminal force in chest leads (mainly V1, V2 and V3) increased, notched P waves in chest leads (mainly V1, V2) and PR segments depression in chest leads (mainly V2, V3 and V4) also belong to typical post OHT ECGs features.
RESUMO
Objective To evaluate the protective value of cardioplegia solution plus metformin in different cardiac arrest time and concentration of metformin in isolated rat hearts .Methods There were 36 male Sprague–Dawley rats divided into six groups randomly, according to the duration of cardioplegic arrest(30 min or 60min) and the concentrations of metformin(50μmol/L or 100 μmol/L) .Langendorff-perfused Sprague-Dawley rat hearts were perfused for 20 minutes with Krebs-Henseleit buffer followed by 30 or 60 minutes of crystalloid cardioplegia or plus metformin (50 or 100 μmol/L) and 60 minutes of reperfu-sion.The left ventricular performance was recorded at 5 time points.The expressions of AMPKαand phosphorylation of AMPKαwere detected by western Blot.The changes of myocardial mitochondria were observed under transmission electron mi-croscope.Results There were no significant differences in Con(A), 50(A) and 100(A) groups in LVDP, ±dp/dtmax and HR.Compared with Con(B) group subjected to 60 minutes of ischemia followed by 60 minutes of reperfusion, the 100(B) group significantly improved myocardial performance , and the ratio of p-AMPKα/AMPKαwas the highest in all 6 groups.The structure of myocardial mitochondria in 100(B) group was better protected than that of Con(B) group.Conclusion These findings suggested that the left ventricular performance was protected in rat heart perfused by cardioplegia plus 100 μmol/L after 60 minutes cardioplegic arrest .The mechanism may be the activation of AMPK and the protection of structures of myocardial mitochondria.
RESUMO
Objective To evaluate the uncertainty of the pseudo-ginsenoside GQ (PGQ) concentration in human plasma by HPLC-MS/MS.Methods The whole process of PGQ determination by HPLC-MS/MS in human plasma was evaluated and the uncertainty caused by repeatability,weighing,standard solution preparation,biological sample preparation,extraction recovery process,recovery,instrument precision and calibration curve fitting were evaluated,respectively.The combined and expanded uncertainty values were both calculated.Results The expanded uncertainty values for low (15.16 ng·mL-1),medium (2 516.67 ng·mL-1) and high (3 902.00 ng·mL-1) levels of PGQ were 1.39,177.74 and 262.69 ng·mL-1,respectively (P =95 %,k =2).Conclusion The uncertainty of the PGQ determination in human plasma by HPLC-MS/MS is mainly caused by recovery,repeatabihty and sample preparation at low concentration,by sample preparation and recovery at medium and high concentration.
RESUMO
Objective To investigate the application of functional assessment to determine the needs of intermediate care services of elderly,and to analyze the needs of intermediate care services of elderly patients in different grades of hospital,different departments and different age.Method 2481 cases of patients aged over 60 years hospitalized due to acute diseases were collected.The ability of activities of daily living (ADL) scale (Barthel index) and limb function were determined in patients aged over 60 years within 1 week after admission as acute diseases.According to the clinical data and scoring scales,the patients were divided into three groups of self-care group without declined independent function of life with Barthel index > 95 points;intermediate care group in whom the ability of daily activities was decreased due to the acute diseases,the function of the body was decreased,and Barthel index was between 45 ~ 95 points;and long-term care group with long term bed rest,severely declined autonomic function or complete dependence and Barthel index less than 45 points,and no opportunity of further recovery.A total of 382 elderly patients (195 male) were in intermediate care group.Analyzed were the intermediate care needs of elderly patients in different levels of hospitals,different departments (including respiratory,cardiovascular,emergency department,geriatrics) and different age.Results The proportion of needs of intermediate care services was 16.1% (194/1205) in third grade hospitals,24.3% (33/136) in grade 2 hospitals,38.1 % (91/239) in grade 1 hospitals,and 7.1% (64/901) in community hospital.In general hospital the proportion of needs of intermediate care services were 24.5 % (13/53) in emergency department,12.1% (4/33) in cardiology department,14.6% (6/41) in respiratory department,and 10.4% (7/ 67) in geriatric department.The proportion of needs of intermediate care services was 19.0% (22/ 116) in age group of 60~69,42.2% (62/147) in age groupof 70~79,and 28.6% (34/119) in age group of over 80 years.Conclusion The needs of intermediate care services are different in different age groups.Patients aged 70 ~ 79 years have the highest needs of intermediate care services.The needs of intermediate care services are different in different grade levels of hospitals and in different departments.